Mentally ill suffer in Afghanistan

December 26, 2008|By Kim Barker, Tribune correspondent

SAMAR KHEL, Afghanistan — Wali Sultani has been chained to the wall of his cell for almost a month. He is wearing the same dirty clothes and he is eating the same diet every day -- bread, black pepper and water.

Sultani, 25, is no criminal. He is mentally ill.

Like almost everything else in war-torn Afghanistan, the mental health system is in shambles, and many Afghans do not understand the concept of mental illness. So they bring people here, to this grubby shrine outside the eastern city of Jalalabad, and chain them to trees when the weather is hot and inside concrete cells when it is cold. And they leave them for 40 days so God can cure them.

The government's Health Ministry would like to close such shrines, but given all the other health crises it faces, places like Samar Khel are low on the list. Government officials say some patients, suffering from high blood pressure, actually improve because of the basic diet.

"Of course, from the Ministry of Public Health perspective, with so many different priorities, it is difficult to go fight these people and their shrines," said Abdullah Fahim, spokesman for the Ministry of Public Health.

On a visit to Samar Khel last month, there were five inmates. Two did not talk, one scraped up pebbles from the dirt floor with a stick. Noor Anwar Buzurg called journalists the sons of communists and imperialists. He used a rock to scratch out a plane on the wall of his cell.

"He has built himself a plane so he can fly out of here," said his uncle, Hazrat Omar, who had brought Buzurg here five days earlier.

Even before being racked by 30 years of war, most of Afghanistan was stuck in a different time, before electricity, before TV, before tractors. War destroyed what few advances the country had made, and the ravages of war led to emotional problems for many people.

A survey by the Afghan government shows that as many as 68 percent of the population suffers from some mental affliction, from anxiety to severe depression, Fahim said.

But there is only one mental hospital in the country, in Kabul, and it has only 60 beds; 20 are dedicated to drug addicts. Other hospitals have mental illness wards, but treatment is hardly a priority.

There are other shrines for the mentally ill sprinkled throughout the country. Others are supposed to cure rabies, paralysis, jaundice or arthritis. One nearby shrine is where people know to collect anyone who has drowned in flooding.

Such shrines are described as religious, but they are frowned on by strict Sunni Muslims, who do not believe in the amulets used to cure the sick here or the concept of jinns, tiny spirits that can possess people.

The shrine at Samar Khel is run by 100 families descended from the founder, Syed Muhammad Ali Shah, who died about 350 years ago. He was known as Mia, and all his descendants, the shrine guardians, are known as the Mias.

The Mias take turns guarding the shrine and accepting donations or payments, although they said they would like an international relief agency to pay to rebuild walls bombed during the Soviet occupation and the civil war. To treat a patient costs as much as $200, a small fortune in Afghanistan.

At this beige mud shrine, which is also the graveyard for all the Mias and which the Mias compare to a hospital, people talk excitedly of those who have been cured: Like the doctor who had undergone shock treatments but was cured by 40 days locked to a tree. And there are other miracles.

"There are lots of scorpions and snakes here, but the scorpions do not sting the sick people, and the snakes do not bite them," Mia Osman said. "A bomb hit here in the middle of the courtyard during the Soviet invasion, but it didn't explode."

Still, the patients did not seem too happy with their treatment. There are 13 concrete cells, and most of the men inside had beards and hair that had grown long, and eyes that looked slightly wild. The cells smelled of human excrement. Sultani jabbed his finger as close as he could to Osman and yelled at the men who had locked him up.

"I will hit you with a rocket-propelled grenade," said Sultani, waving his finger. "You are very bad people. Infidels are better than you Muslims."

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kbarker@tribune.com

Scars beyond the war zone

See photos of mental health facilities in Afghanistan at chicagotribune.com/mental